Murad ATMACA, Mehmet Gürkan GÜROK, Faruk KILIÇ, Hanefi YILDIRIM

Panik Bozukluğu olan Hastalarda Kaudat Çekirdek Hacimleri ve Klinik Değişkenlerle İlişkisi

Amaç: Panik Bozukluk tanı özellikleri iyi belirlenmiş, anksiyete bozuklukları içerisinde sınıflandırılan ve üzerinde ilgiyle durulmuş bir psikiyatrik bozukluktur. Son yıllarda panik bozukluk hastalarında yapılan nöro-görüntüleme çalışmalarında, hastalığın belirleyici belirti ve bulguları ile ilintili olabilecek anormallikler saptanmıştır. Çalışmamızda; panik bozukluğun etyopatogenezi daha iyi anlayabilmek adına, hastalarda kaudat nük- leusdaki morfometrik değişiklikleri araştırmayı amaçladık. Gereç ve Yöntem: Çalışma süresince Fırat Üniversitesi Hastanesi Psikiyatri Kliniği ve Polikliniği’ne başvuran ve yatarak ya da ayaktan tedavi gören, DSM-IV tanı ölçütlerine göre Panik Bozukluk tanısı almış ve çalışma ölçütlerine uyan 20 hasta ile 20 sağlıklı kontrol grubu çalışmaya dahil edilmiş- tir. Hastalara Sosyodemografik ve Klinik Bilgi Formu, Hamilton Depresyon Derecelendirme Ölçeği, Hamilton Anksiyete Ölçeği ve SCID-I uygulan- mıştır. Hasta ve kontrol grubunda manyetik rezonans görüntüleme kullanılarak total beyin, gri madde, beyaz madde kaudat nükleus bölümlerinin volümetrik ölçümleri gerçekleştirilmiştir. Bulgular: Hasta grubu ile sağlıklı kontroller arasında, total beyin volümü, total beyaz ve gri madde volümü açısından fark gözlenmezken, hasta grubunda sağ ve sol kaudat nükleus hacmi sağlıklı kontrollere kıyasla önemli oranda küçük bulundu. Sonuç: Kaudat nükleusun hem hastalığın patofizyolojisi hem de klinik seyrinde önemli ilişkisinin olabileceğini söyleyebiliriz. Bu bölgenin fonksiyo- nel özelliklerini inceleyen görüntüleme teknikleri ve bilişsel işlevleri inceleyen testlerin birlikte ele alındığı çalışmalar daha önemli ve verimli sonuç- lara ulaşmamızı sağlayacağı düşüncesindeyiz.

Caudate Nucleus Volume on Patients with Panic Disorder and Relationship with the Clinical Variability

Objective: Panic disorder is a psychiatric disorder whose properties of diagnosis were well-determined, can be classified in anxiety disorders. Recently, in neuroimaging studies, some abnormalities that may be related to the signs and symptoms of the disease have been shown. In our study we aimed to investigate the morphometric alterations of caudate nucleus in panic disoerder patients to understand the pathophsiology. Material and Method: The study comprised 20 panic disordered patients who had applied to Firat University Hospital Department of Psychiatry as out- or in- patients and had been diagnosed with panic disorder according to the criteria of DSM-IV and 20 healthy controls. The patients were admi- nistered the sociodemographical data form, Hamilton Depression Rating Scale, Hamilton Anxiete Rating Scale and SCID. The volumetric measure- ment of total brain, gray matter, white matter, caudate nucleus was performed on patients and control group by using MRI. Results: For the whole brain volume, total white and gray matter volumes, there were no differences observed between the patients and healthy controls while the patient group had significantly smaller left and right caudate nucleus volumes compared with healthy controls. Conclusion: This can be considered caudate nucleus has an important relationship with both pathophysiology and clinical course of the disease. We suggest that the investigations which use together the visualisation technique that examine the functional qualifications of this area and the tests research the cognitive functions, make us to provide to reach more important and effective results.

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